Health Care On The Prairie

Well, that was an interesting 11 days. This is the first time I’ve sat at my desk since April 16. Let me tell you a bit about that day. I spent much of the day digging in the dirt in the back yard preparing for our landscaping project. About suppertime I felt a nagging pain in my right ribcage, which I diagnosed as having done just a little more damage to the herniated disk in my back. Took some drugs. Didn’t help. Pain got worse. About 10:30 I ignored the instructions on the bottle and took some more drugs and went to bed. Didn’t help. By 11:30 I felt like I had this knife sticking me in the ribs, and I was scaring the bejesus out of Lillian, so we jumped in the car and went to the ER.

First diagnosis: Pleurisy. Second diagnosis: Kidney stone. Shift change at ER, new ER doctor, said let’s do a CT scan. Third diagnosis at 4 a.m.: pulmonary embolism. Seems a big old blood clot had formed somewhere in one of my legs, shook itself loose and decided to go on a tour of my body. Went running up my leg all the way to my heart, didn’t like it there, kept going and took up residence in my pulmonary artery. Started to break up, sending these shooting pains through my right lung. That was the pain I was feeling in my rib cage.

Now, 11 days later, after two bouts with pneumonia and one small kidney failure, I’m back at Red Oak House. The clots are dissolving. Blood is once more flowing through my pulmonary artery. A few months of good drugs and respiratory and physical therapy I’ll be fine. There was one point at which, I later learned, that I might have been in some trouble. While I was somewhere off in la-la-land Saturday morning, Lillian and her sister Beckie demanded a specialist, who arrived later in the day and corrected my medication. Thanks to those two, and my sister Jill, a former nurse who helped us understand technical stuff, I am here today.

It was a long, boring 11 days. For those of you who called, visited and sent flowers, balloons and letters, Thank You. For those of you who didn’t, Thank You too. To be truthful, with the shortness of breath and the pain, I really didn’t want to talk to anyone for much of that time.

I’m fine. Bismarck’s medical system worked. It is amazingly sophisticated, far, far beyond what I remember from the last time I went through one of these blood clot episodes 12 years ago. So I thought today I would share with you something I wrote a few years ago about health care here on the prairie, which some of you may remember from the first time it appeared in print.

My 83-year-old mother is a resident of Western Horizons Care Center in Hettinger, North Dakota, population 1,307, 14 of them doctors serving a regional medical facility that cares for residents of a 5,000 square mile expanse of prairie at the intersection of North Dakota, South Dakota and Montana, where the population averages just over one person per square mile.

In her younger days, my mother worked as director of nursing at Western Horizons (then known as Hillcrest, for its location--only coincidentally, I think, on a hill across the highway from the Hettinger cemetery, where many of the residents can look down on the resting place of spouses and other loved ones) while she and my dad struggled to put seven kids through college. Today, she lives there and has most everything she needs, including her large circle of friends and, most importantly, for someone who suffers the normal aches and pains and medical crises of an 83-year-old, her old friend and longtime doctor, Joe Mattson.

I visited with Joe a while back at Hettinger’s hospital, where he had put my mom for a few days because an infection had sent her temperature soaring and he needed to get it under control. Joe’s a generous, kind-hearted country doctor who forsook big city riches in the 1960’s for a chance for he and his wife Pat to raise their children - seven in all, three of their own and four adopted - on the prairie. He and a couple other visionary doctors built this great medical center to bring health care to this sparsely populated area - a clinic, a hospital, a nursing home and an assisted living facility - and provide more than 200 jobs, perhaps a fourth of all the jobs in Hettinger today.

I confess I don’t know him well. He came to Hettinger after I left for college, and our acquaintance is a result of being unable to avoid bumping into each other in a small town on my visits home. I enjoy him immensely, a big bear of a man with a booming voice and unruly hair, and whose slightly rumpled and gruff appearance belies a bedside manner of Mother Theresa.

He visited my mother’s room late on a Friday afternoon, at the end of a long day in an even longer week, appearing untired at a time when most men well into their 60’s would just be looking for a recliner and a little supper. He looked at the charts, puzzled over the temperature and infection, and then plopped down in a chair and struck up a conversation, of grandkids and bad backs and summer vacations and the kind of thing old friends talk about.

More than 15 minutes he sat there, reassuring me, and through me, my mom, that nothing abnormal is going on here in a body that’s just getting a little older and a little harder to manage some days. We’ll just send in some more antibiotics and get this thing fixed.

He talked of his two pre-school grandkids who were staying with him and Pat while a daughter completed a move without them in her hair. He talked about his weekend schedule. He’s a deacon in the Catholic Church in Hettinger, and this coming weekend the priest at Reeder, 13 miles down the road, is on vacation, so Joe was going to run over there and give communion on Sunday. And then he left--a 20 minute hospital room call, and I suspect he had more before he went home to Pat and those grandkids.

Later, approaching dark, the nurse came back in and said Dr. Mattson had just called and thought maybe my mom should take one of these pills before she went to sleep. He’d been thinking about her, even at home hours later, and wanted her to be more comfortable through the night.

Mom slept well indeed, and Saturday morning felt good, so I went home, promising to call. We talked a couple of times Saturday, and again Sunday afternoon when she told me she probably would go home Monday. “Has the doctor been in today?” I asked.

“Oh, yes, and he says my temperature is down and my blood test looks good, and I can go home tomorrow. And guess what? He had just come from Reeder when he stopped to check on me, and he said ‘Phyllis, I bet you didn’t get communion this week, did you?’”

“And he reached into his pocket and pulled out his little box and we said a prayer and he gave me communion.”

Body and soul.

And we wonder why we live in North Dakota?